The Journey to Citizenship - Deinstitutionalisation in Finland

Author: Simon Duffy

Recently I was invited to Finland to talk to people with intellectual disabilities, families, service providers, local and central government. I spoke about the journey towards citizenship and I tried to describe some of the innovations that can help bring about a fairer society where people with intellectual disabilities can achieve their human rights.

Finland shares, with other Scandinavian countries, the quite proper assumption that the state has an important duty to ensure that everyone in society gets the financial and practical support necessary to be a citizen. However, many thousands of adults and children still live in institutions. Too many people are excluded from citizenship.

Institutions do not work

Institutions:

• Cut people off from ordinary life, work, leisure and society.
• Stop people from being in control of their own life
• Damage families and encourage crises
• Make it difficult for people to be friends, employees, neighbours and volunteers

The good news is that Finland has decided to close their institutions. But the bad news is that the current plan risks replacing the old institutions with new institutions - smaller institutions - but still institutions.

If Finland spends large amounts of time, money and energy creating a new institutional service system in its communities, then it will create a new system that is already out-of-date.

People with intellectual disabilities do not need institutions, people do not want institutions, people want citizenship. 

For citizenship means:

• Lives with purpose, doing things that make sense to us
• Control over our own lives, and help to be in control
• Money to be independent, including any money we need for support
• Homes, ordinary homes in our own communities, living with the people we want to
• Getting help from others in our community
• Working, giving and sharing our talents

These are the basic requirements of citizenship, they are also basic human rights. Putting people in institutions - even small institutions - may even risk contravening the UN Convention of the Rights of Disabled People.

A mistake, which is all too easy to make, is to believe that the institution is a building; and that all we need to do is to close the institution, but the institution is really a system of power and control. To really close institutions it is necessary to shift power and control back to people with intellectual disabilities and their families. Of course, to change systems of power and control is not easy - but it is the real and fundamental challenge.

Finland, like every other Western country, is also struggling with demands of the new austerity. It aims to cut its public sector budget and to ensure that its investments are sustainable for the future. So now is not the time to invest limited public resources in services that are already out-of-date. Now is the time to invest in citizenship.

Citizenship is not the expensive option; shifting resources away from institutions and into citizenship will increase all dimensions of social and economic value:

• People will use, develop and share their skills with other people
• Money will move into local communities and will grow local markets and capacity
• Communities will grow stronger, more skilful and more inclusive
• Wasteful expenditure in unwanted services will be replaced with valued services

To really support citizenship Finland will need systems for:

• Individual budgeting, so that people can design and control their own support
• Flexible housing funding, so that people can access ordinary housing
• Supported employment, so that people can get ordinary jobs
• Advocacy, information and peer support, so that people are informed and powerful
• A fair tax-benefit system that encourages greater contribution

These are the key elements of a citizenship support system.

One of Finland’s great assets is the brilliance of its design. Perhaps this could be one way to help rethink its current approach to deinstitutionalisation. Citizenship requires that we can design our own lives, so that our lives work well for us, so that we can make the best of our talents and capacities.

Institutional provision is the opposite of good design - it is inflexible and it does not allow the person to become the designer of their own life. Small institutions are only a little better than large institutions; they will not help Finns to extend their excellence in design to the whole of their society. Once the new wave of smaller institutions have been developed it will take at least 20 years to then close them. This will put Finland 20 years behind countries, like Scotland, that moved directly from institutional provision towards citizenship support systems. Finland should aim to improve on current best-practice not to repeat the mistakes of the countries who are now having to disinvest from institutional community services.

I am sure Finland will succeed in making positive changes. After meeting a wide-range of wonderful people, self-advocates, family members and professionals, I am confident that Finland will find a better way. But my hope is that they do not lose too much time along the journey.

Acknowledgement

My thanks to everyone at FAIDD (Finnish Association on Intellectual and Developmental Disabilities) the Service Foundation for People with an Intellectual Disability, the Finnish Association for Persons with Intellectual Disabilities and FDUV for their kindness, welcome and support. My thanks to everyone who spoke with me and share their stories and wisdom, and special thanks also to Susanna Hintsala, Elina Antikainen, Kirsi Konola, Vivien Cooper and Christy Lynch.

The publisher is the Centre for Welfare Reform.

The Journey to Citizenship - Deinstitutionalisation in Finland © Simon Duffy 2012.

All Rights Reserved. No part of this paper may be reproduced in any form without permission from the publisher except for the quotation of brief passages in reviews.